Trends in condom use among MSM in the United States: the role of antiretroviral therapy and seroadaptive strategies
Open accessAbstract
OBJECTIVE: Evaluate changes in condomless anal sex at last sex among men who have sex with men (MSM) and assess if these changes are associated with the adoption of serosorting and biomedical prevention. DESIGN: The National HIV Behavioral Surveillance is a crosssectional survey done in up to 21 cities in 2005, 2008, 2011 and 2014. METHODS: MSM were recruited through venue-based sampling. Among men reporting at least one male partner, we evaluated changes in condomless anal sex at last sex with a partner with (1) HIV-concordant (proxy for serosorting) or (2) HIV-discordant (discordant/unknown) status. We hypothesized that if concordant condomless sex was increasing while discordant was stable/declining, the increases could be driven by more men attempting to serosort. We used generalized estimating equations assuming a Poisson distribution and robust variance estimator to explore whether temporal changes in the outcomes varied by selected characteristics. We also assessed changes in condomless anal sex by antiretroviral therapy (ART) use among HIV-positive MSM. RESULTS: Among 5371 HIV-positive MSM, there were increases in concordant (19% in 2005 to 25% in 2014, P < 0.001) and discordant condomless sex (15 to 19%, P < 0.001). The increases were not different by ART use. Among 30 547 HIV-negative MSM, concordant (21 to 27%, P < 0.001) and discordant condomless sex (8 to 13%, P < 0.001) increased. CONCLUSION: Our data suggest that condom use decreased among MSM and that the trends are not explained by serosorting or ART. Promotion of condoms and increased access to preexposure prophylaxis are vital to ensure that the benefits of ART in reducing transmission of HIV are not undermined.
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MSM might be at increased risk for HIV and other STIs because of their sexual network or behavioral or biologic factors, including number of concurrent partners, condomless sex, anal sex, or substance use.
“MSM might be at increased risk for HIV and other STIs because of their sexual network or behavioral or biologic factors, including number of concurrent partners, condomless sex, anal sex, or substance use (180–182).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [181]
The Introduction and Discussion (page numbers unavailable) describe HIV transmission risk associated with condomless anal sex among MSM, including differences in risk by sexual position. The cited paper does not address the claim’s other specified factors—sexual networks, concurrent partners, or substance use—or establish the broader claim about other STIs. (LLM, conf=0.86)
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- Authors
- Paz-Bailey, G., Mendoza, M. C. B., Finlayson, T., Wejnert, C., Le, B., Rose, C., Raymond, H. F., & Prejean, J.
- Affiliations
- Centers for Disease Control and Prevention (US)
- ORCID
- Venue
- AIDS
- Published
- 2016-07-31
- Volume
- 30
- Issue
- 12
- Pages
- 1985-1990
- ISSN
- 0269-9370 (ISSN-L)
- PMC
- PMC5838316
- OpenAlex
- W2346128149
- Cited by
- 143
- References
- 19
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 7 · 2023: 11 · 2022: 16 · 2021: 20 · 2020: 17 · 2019: 19 · 2018: 16 · 2017: 20 · 2016: 6
- FWCI
- 18.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- AIDS (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Keywords
- condomless anal sex, men who have sex with men, serosorting, antiretroviral therapy, HIV prevention, pre-exposure prophylaxis, HIV transmission, HIV-negative men, HIV-positive men
- MeSH terms
- Adolescent, Adult, Humans, Male, Middle Aged, Surveys and Questionnaires, Sexual Behavior, United States, HIV Infections, Condoms, Homosexuality, Male, Disease Transmission, Infectious, Anti-Retroviral Agents, Young Adult
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